Frequently asked questions

As a starting point, your clients should think about their lifestyle, budget and the conditions or illnesses which concern them the most.

Comprehensive covers eligible medical costs from diagnosis to treatment for acute conditions, cancer and mental health, for as long as they’re a Bupa member.

Treatment and care covers all their eligible treatment for acute conditions after a diagnosis by a consultant through the NHS or self funded, for as long as they’re a Bupa member.

With our full cancer cover, there are no limits on how long your clients treatment lasts or how much it costs. They must visit a hospital or health centre from their chosen network and a consultant that we recognise and charges within our allowances.

Bupa By You covers your clients for new eligible conditions that occur once the cover has started, so they won't be able to use it for medical conditions or symptoms that they had before their cover started. There are also certain treatments and conditions that, whichever plan your clients choose, will not be covered, for example chronic long-standing conditions or cosmetic surgery. Details of all of the exclusions in place can be found in the Bupa By You policy guide.

They’ll be covered from the moment they’ve agreed on the level of cover that's right for them and they’ve set up their Direct Debit. They can cancel their cover within 21 days of the cover starting and receive a full refund providing they’ve not made a claim. Once they’re a member they’ll be sent all of the documentation that details what is and isn't covered and how they can get in touch with us should they need to claim.

Before your client’s renewal we’ll send them a renewal pack which includes details of their new premium.

Your clients can add their partner and/or their children (including newborn or adopted children) as dependants on their membership at any time.

We’ll write to your client at least 28 days before their renewal date, and your client's annual cover will automatically be renewed unless they decide to end their cover. Bupa By You is adaptable health insurance so each year at renewal your client can change elements of their cover if their circumstances change. We will include information on renewal options in the customer's renewal pack.

If one of your clients already has Bupa health insurance and wants to find out more about their policy, please visit our members’ area.

If your client attends a hospital or clinic as an ‘outpatient’ it means they are not admitted to hospital and don’t need to stay overnight for the appointment.

A ‘day-patient’ is when your client is admitted to hospital for treatment, but doesn’t need to stay overnight. An ‘inpatient’ is when your client attends hospital for treatment, and stays in hospital overnight or longer.

By adding an outpatient allowance, your client is able to reduce their premiums. A lower allowance will reduce the cost of their cover and a higher allowance will increase the cost. Watch this video to find out more about our outpatient benefit allowance and how it can impact premiums.

View our ‘what are outpatient benefit' allowances video>

Our outpatient allowances apply to tests like x-rays, consultations with a specialist surgeon or doctor, or therapies like physiotherapy. Once your client has exceeded their annual outpatient allowances, they would need to fund further private tests, consultations and therapies as an outpatient themselves. MRI, PET and CT scans are paid in full as long as your client uses a Bupa-recognised facility.

With Bupa By You, full cancer cover can be added with our Comprehensive and Treatment and Care products.

With Bupa full cancer cover, there are no limits on how long treatment lasts or how much it costs, for as long as your client has Bupa health cover. Your client must use a hospital or health centre from their chosen Bupa network and a consultant that we recognise and charges within Bupa rates (a fee-assured consultant).

Bupa membership gives your clients access to eligible breakthrough cancer drugs and treatments often before they are available on the NHS or approved by NICE as long as they are evidence-based.

We will always evaluate requests to fund new or experimental treatment.

Some insurers only provide treatment for the primary cancer (the cancer your clients are initially diagnosed with), Bupa will cover them even if their cancer spreads, if they have selected full cancer cover.

When we say full cancer cover it means your clients have no limit to how much they can claim for eligible treatment provided that they use a Bupa recognised consultant we have already agreed fees with (fee assured), within their chosen Bupa hospital network.

As long as there is sound clinical evidence to demonstrate benefit, we will fund them.

If your clients select full cancer cover, we will provide cover and support at every stage of their cancer, including palliative treatment, even if their cancer is incurable. Bupa will cover this as long as it is eligible treatment.

When we say full cancer cover it means your clients have no limit to how much they can claim for eligible treatment provided that they use a Bupa recognised consultant we have already agreed fees with (fee assured), within their chosen Bupa hospital network.

No - We don’t take family history of cancer into account when deciding whether or not to offer cover to a new customer.

We don’t pay for treatments that are not evidence-based. The only exception is when the treatment is part of a clinical trial, the protocols of which have been reviewed and approved by us.

Our support team is able to give members and their carers or family, advice related to their specific situation and discuss options for being treated at home (where your client’s consultant feels this is clinically appropriate). Our informed decision making service helps members understand the options available to them and the information they need to be able to make decisions about their own care.

If your clients are treated by a Bupa fee assured consultant in a Bupa recognised facility that is within their chosen Bupa hospital network, we will fund all of their eligible diagnostic tests and investigations and all eligible treatment for cancer providing they have selected our full cancer cover.

When we say full cancer cover it means your clients have no limit to how much they can claim for eligible treatment provided that they use a Bupa recognised consultant we have already agreed fees with (fee assured), within their chosen Bupa hospital network.

If your client has full cancer cover and they opt to receive their cancer treatment in an NHS hospital or at home and the treatment is funded by the NHS, we offer an NHS cancer cash benefit which allows members to claim £100 for every day/night they receive eligible inpatient, day-patient, outpatient or home cancer treatment. For oral drug treatment for cancer, it’s paid for each three weekly interval or part thereof.

When we say full cancer cover it means your clients have no limit to how much they can claim for eligible treatment provided that they use a Bupa recognised consultant we have already agreed fees with (fee assured), within their chosen Bupa hospital network.

Yes – if they have full cancer cover Bupa gives them the option to receive their chemotherapy at home (where your client’s consultant feels this is clinically appropriate) safely and from a specialist nurse. Treatment at home means there is as little disruption to their life as possible.

When we say full cancer cover it means your clients have no limit to how much they can claim for eligible treatment provided that they use a Bupa recognised consultant we have already agreed fees with (fee assured), within their chosen Bupa hospital network.

Any customer can attend a specialist centre within their network. Treatment for the most commonly diagnosed cancers (breast, bowel and prostate) is provided through our unique network of specialist cancer centres, which guarantee they will be treated by a cancer specialist team.

Payments are usually made directly by Bupa when they use our fee assured consultants and their chosen Bupa hospital network for eligible treatment. So there is no need to pay any costs themselves (except where an excess payment is applicable).

Our online cancer health hub contains information which has been developed to provide our members and their friends and families with helpful information about how and why cancer develops and details of the range of cancer treatments available.

No. However, we will need to ask some questions about:

• their age, gender at birth and medical history
• whether they smoke
• their current state of health
• their occupation

Health insurance does not generally cover pre-existing conditions. If they’ve never had health insurance, we’ll need to base our decision on the cover we can offer your clients on their past seven years’ medical history. So, if they have symptoms which they know could cause problems in the future, they’ll need to tell us straightaway.

With moratorium underwriting, we’ll ask your client and your client's GP to complete a pre-treatment form each time they claim so we can confirm that the condition they’re claiming for is new, or if they had it before they're policy started. If they, or anyone else on they're policy, had a medical condition before it starts, the condition may be covered, as long as they haven’t had any symptoms, treatment for it, or any medical advice about it for two consecutive years after they've taken out the policy.

The No Claims Discount scale below shows the levels available and discounts which apply to each level. As a new member your client will have entered at level 12 (65% discount highlighted below). If we have paid no claims for your client during the 12 months (10 months in their first year of cover) prior to their renewal premium being calculated, their No Claims Discount will increase by one level on the scale. The maximum No Claims Discount available is level 14 (70% discount).

The maximum number of levels your client can decrease at renewal is three.

The No Claims Discount only applies to premiums for their core health insurance. Claims they may make in relation to any add on's, dental Allowance, Digital GP, HealthLines or NHS Cash Benefit do not count as claims in the assessment of the no claims discount. In addition, claims we pay that fall entirely within any excess will not be counted.

No claims discount level	Discount applied on premium
1	0%
2	10%
3	20%
4	27.5%
5	35%
6	40%
7	45%
8	50%
9	55%
10	59%
11	62%
12	65%
13	68%
14	70%

The No Claims Discount scale works as follows:

Claims payments made during the year before we calculate the premium for the next insurance year	Movement on the scale at the next renewal date (subject to a maximum of level 14 and a minimum of level 1)
£0 paid	Move up the scale by one level
Between £0.01 - £300 paid	Don’t move on scale
Between £300.01 - £1200 paid	Move down the scale by two levels
More than £1200 paid	Move down the scale by three levels

The No Claims Discount is only based on claims paid by us and so any claim your client makes won’t be taken into account until the payment has been processed.

Any claim that falls entirely within their excess will not impact their No Claims Discount level.

For more detail please refer to the No Claims Discount Information for Bupa By You insert.